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Mini-laparoscopically guided percutaneous gastrostomy and jejunostomy.
Gastrointest Endosc. 2003 Sep; 58(3):434-8.GE

Abstract

BACKGROUND

Percutaneous endoscopic tube placement can be problematic under certain circumstances: absence of transillumination of the abdominal wall, percutaneous jejunostomy in patients with a PEG tube and recurrent aspiration, enteral feeding access after gastrectomy, and obstruction of the upper GI tract. As an alternative in these problematic situations, a technique was developed for placing feeding tubes under visual control by using mini-laparoscopy.

METHODS

Placement of a feeding tube with mini-laparoscopy with the patient under conscious sedation was considered for 17 patients in whom standard PEG placement was impossible. Techniques used were the following: combined mini-laparoscopy/endoscopy for placement of a percutaneous gastrostomy or jejunostomy, and mini-laparoscopic-guided direct tube placement in cases of obstruction of the upper GI tract.

OBSERVATIONS

In 13 patients, mini-laparoscopic-assisted tube placement was successful. In 4 patients, adhesions or peritoneal carcinomatosis prevented laparoscopic visualization of the stomach or small bowel. The combined mini-laparoscopic/endoscopic approach allowed a successful insertion of gastric tubes in 6 patients and jejunal tubes in 4 patients. Direct insertion of a percutaneous endoscopic jejunostomy tube without enteroscopy was feasible in all 3 patients with obstruction of the upper GI tract. No complication occurred.

CONCLUSIONS

Mini-laparoscopy-assisted tube placement is a simple and safe alternative when endoscopic percutaneous tube placement is problematic or not feasible.

Authors+Show Affiliations

Department of Medicine, Johannes Gutenberg University, Mainz, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14528224

Citation

Denzer, Ulrike, et al. "Mini-laparoscopically Guided Percutaneous Gastrostomy and Jejunostomy." Gastrointestinal Endoscopy, vol. 58, no. 3, 2003, pp. 434-8.
Denzer U, Mergener K, Kanzler S, et al. Mini-laparoscopically guided percutaneous gastrostomy and jejunostomy. Gastrointest Endosc. 2003;58(3):434-8.
Denzer, U., Mergener, K., Kanzler, S., Kiesslich, R., Helmreich-Becker, I., Galle, P. R., & Lohse, A. W. (2003). Mini-laparoscopically guided percutaneous gastrostomy and jejunostomy. Gastrointestinal Endoscopy, 58(3), 434-8.
Denzer U, et al. Mini-laparoscopically Guided Percutaneous Gastrostomy and Jejunostomy. Gastrointest Endosc. 2003;58(3):434-8. PubMed PMID: 14528224.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mini-laparoscopically guided percutaneous gastrostomy and jejunostomy. AU - Denzer,Ulrike, AU - Mergener,Klaus, AU - Kanzler,Stefan, AU - Kiesslich,Ralf, AU - Helmreich-Becker,Ilka, AU - Galle,Peter R, AU - Lohse,Ansgar W, PY - 2003/10/7/pubmed PY - 2004/1/22/medline PY - 2003/10/7/entrez SP - 434 EP - 8 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 58 IS - 3 N2 - BACKGROUND: Percutaneous endoscopic tube placement can be problematic under certain circumstances: absence of transillumination of the abdominal wall, percutaneous jejunostomy in patients with a PEG tube and recurrent aspiration, enteral feeding access after gastrectomy, and obstruction of the upper GI tract. As an alternative in these problematic situations, a technique was developed for placing feeding tubes under visual control by using mini-laparoscopy. METHODS: Placement of a feeding tube with mini-laparoscopy with the patient under conscious sedation was considered for 17 patients in whom standard PEG placement was impossible. Techniques used were the following: combined mini-laparoscopy/endoscopy for placement of a percutaneous gastrostomy or jejunostomy, and mini-laparoscopic-guided direct tube placement in cases of obstruction of the upper GI tract. OBSERVATIONS: In 13 patients, mini-laparoscopic-assisted tube placement was successful. In 4 patients, adhesions or peritoneal carcinomatosis prevented laparoscopic visualization of the stomach or small bowel. The combined mini-laparoscopic/endoscopic approach allowed a successful insertion of gastric tubes in 6 patients and jejunal tubes in 4 patients. Direct insertion of a percutaneous endoscopic jejunostomy tube without enteroscopy was feasible in all 3 patients with obstruction of the upper GI tract. No complication occurred. CONCLUSIONS: Mini-laparoscopy-assisted tube placement is a simple and safe alternative when endoscopic percutaneous tube placement is problematic or not feasible. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/14528224/Mini_laparoscopically_guided_percutaneous_gastrostomy_and_jejunostomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(03)00024-5 DB - PRIME DP - Unbound Medicine ER -